OBJECTIVETo observe the clinical characteristics of triceps brachii tendon rupture at olecranon ending.

METHODSFrom June 2005 to November 2011,19 patients with triceps brachii tendon rupture at olecranon ending were treated with surgical technique. Among the 19 patients, 7 patients were male, with an average age of 24.1 years old (ranged, 15 to 41 years old); 12 patients were female, with an average age of 51.4 years old (ranged, 16 to 73 years old). Eight patients had injuries in the left elbows, and 11 patients had injuries in right elbows. Seventeen patients had injuries induced by walking fall and 2 patients had injuries induced by falling down. Thirteen patients were simple triceps brachii tendon rupture at olecranon ending, 6 patients were associated with other elbow injuries. Five patients were associated with radial fracture; 1 patient with capitellum fracture; 1 patient with coronoid process fracture; 1 patient with epitrochlear. All the lateral radiographs of the injuried elbow demenstrated the flecks of avulsed osseous material from the olecranon (flake sign). The associated injuries had the homologus presence. All the patients were treated with surgical techniques:15 patients were treated with figure-of-eight tension-band wire; figure-of-eight tension band wire and Kirschner wire in 1 patient; wire cerclage in 1 patient; nonabsorbable suture in 2 patients. The associated injuries were treated simultaneously. Plaster was applied after operation in 2 patients with heavier elbow associated injuries, other patients without any external fixation. The Mayo elbow score were observed to determinate the function of the elbow.

RESULTSAll the patients were followed up, 1 patient died of other disease at one year after operation, the other 18 patients were followed up with an average of 47.9 months (ranged from 14 to 91 months). According to the Mayo elbow score, 16 patients got an excellent result and 2 good.

CONCLUSIONTraumatic rupture of triceps brachii tendon at olecranon ending is not a rare injury, which is common in female older than fifty and in male younger then thirty. Surgical results are generally excellent. But dysfunction frequently remains in patients with associated elbow injuries.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Olecranon Process ; injuries ; Rupture ; Tendon Injuries ; surgery

BACKGROUND: The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs. triceps-sparing approach for patients with distal humerus intercondylar fracture. METHODS: The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications. RESULTS: Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75; P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI: -2.56 to 2.89; P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach. CONCLUSIONS This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.
Elbow Joint/surgery* ; Fracture Fixation, Internal ; Humans ; Humeral Fractures/surgery* ; Humerus ; Olecranon Process/surgery* ; Osteotomy ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVETo study clinical effects of surgery for the treatment of Mayo II B comminuted fracture in ulna olecranon.

METHODSFrom May 2008 to March 2015, a total of 37 patients with Mayo II B comminuted fracture in ulua olecranon were treated, including 20 males and 17 females, ranging in age from 40 to 65 years old ,with an average of 53 years old. All the patients were treated with open reduction and internal fixation within 4 to 7 days after injuries. All the patients had pain and functional disorder uf elbow joint. The X-ray and CT examination showed ulna olecranon comminuted fracture of Mayo II B. Postoperative complications were observed ,and Broberg-Morrey criteria was used tu evaluate therapeutic effects.

RESULTSAll the patients were followed up ,and the duraiton ranged from 9 to 30 months ,with a mean of 15 months. Two patients had surface infection around incision ,and were healed by changing dressings. No other complications occurred such as needle slipping to stimulate skin ,screw loosening and wire broken. One patient had slight uneveness of joint surface without obvious functional disorder. According to Broberg-Morrey elbow fracture curative effect criteria, 11 paients got an excellent result, 24 good and 2 fair,and the total score was 87.0 ± 7.3.

CONCLUSIONFor the Mayo II B comminuted fracture in ulna olecranon, preoperative preparation, intraoperative restoring of the articular surface smooth and reasonable internal fixation, and postoperative rehabilitation actively, can obtain satisfactory clinical effects.

Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Olecranon Process ; injuries ; Ulna Fractures ; surgery

Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Olecranon Process ; injuries ; surgery ; Suture Techniques ; Ulna Fractures ; surgery

OBJECTIVE: To retrospectively analyze the clinical efficacy of olecranon osteotomy approach in the treatment of Dubberley type Ⅲ coronal fractures of the distal humerus and summarize the treatment experience. METHODS: From January 2016 to June 2020, 17 patients (5 males and 12 females) with Dubberley type Ⅲ coronal fractures of the distal humerus were treated by olecranon osteotomy approach. The age ranged from 37 to78 years old with an average of (58.5±12.9) years old. According to Dubberley classification, there were 5 cases of type Ⅲ A and 12 cases of type Ⅲ B. The curative effect was evaluated using the Borberg-Morrey elbow function score. The flexion, extension and rotation range of motion of the elbow joint, complications and postoperative imaging evaluation were recorded. RESULTS: All the 17 patients got bony union. The follow-up time ranged from 12 to 33 months with an average of (15.6±5.6) months. There was 1 case of ischemic necrosis of capitulum humeri, 2 cases of traumatic arthritis and 1 case of heterotopic ossification, 1 case of malunion of fracture. The range of motion was (114.80±19.50) °. The Broberg-Morrey score was 85.3±8.2, excellent in 5 cases, good in 9 cases, fair in 3 cases and poor in 0 case. CONCLUSION Through olecranon osteotomy approach, the articular surface of distal humerus could be fully exposed, and the operation is convenient. Anatomical reduction and rigid fixation of the articular surface of distal humerus are the key factors for the succesful outcome.
Male ; Female ; Humans ; Adult ; Olecranon Process/surgery* ; Elbow Joint/surgery* ; Humeral Fractures/surgery* ; Retrospective Studies ; Fracture Fixation, Internal/methods* ; Humerus/surgery* ; Treatment Outcome ; Range of Motion, Articular

OBJECTIVE: To compare the clinical effect of three types of Kirschner wire tension band for olecranon fracture. METHODS: The clinical data of 64 patients with olecranon fracture treated by Kirschner wire tension band fixation from March 2016 to May 2020 were retrospectively analyzed. Among them, 19 patients were treated with intramedullary K-wires fixation(group A) including 8 males and 11 females with an average of (48.2±18.3) years old, 3 patients were typeⅠ, and 16 patients were typeⅡ according to Mayo classification;20 patients were treated with transcortical K-wires fixation (group B) including 13 males and 7 females with an average of (43.5±20.4) years old, 3 patients were typeⅠand 17 patients were typeⅡ according to Mayo classification;25 patients were treated with perforated Kirschner wire(group C) including 15 males and 10 females with an average of (55.2±17.5) years old, 4 patients were typeⅠand 21 patients were typeⅡ according to Mayo classification. The operative time, intraoperative blood loss, times of Intraoperative fluoroscopy, fracture healing time and complications of 3 groups were compared. At the final follow-up, elbow function was assessed using the Mayo Elbow Function Scale. RESULTS: There were differences in operative time, intraoperative fluoroscopy times, postoperative VAS and soft tissue irritation among the three groups(P<0.05). The operative time, intraoperative fluoroscopy times in group A and C was better than that in group B. The postoperative VAS score, skin irritability in group C was better than that of group B. The difference was statistically significant on Mayo elbow function score at the final follow-up among three groups(P<0.05), the scores of group A and C were higher than that of group B. CONCLUSION Compared with transcortical K-wires screw fixation, both intramedullary K-wires screw fixation and perforated Kirschner wire fixation, which can significantly reduce the occurrence of soft tissue irritation, reduce surgical complications and shorten the operation time.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Young Adult ; Bone Wires ; Retrospective Studies ; Fracture Fixation, Internal ; Ulna Fractures/surgery* ; Olecranon Process/surgery* ; Inflammation ; Treatment Outcome

OBJECTIVETo evaluate the clinical effects by comparing three different fixation methods: tension band, hollow lag screw and anatomical plate.

METHODSFrom January 2010 to January 2012, 82 patients with olecranon fractures who underwent surgical treatments were followed-up. All the patients were divided into three groups: tension band fixation group (group A), hollow lag screw fixation group (group B), anatomical plate fixation (group C). In group A, there were 35 patients, including 19 males and 16 females, ranging in age from 32 to 49 years old, with an average of (43.6 ± 8.7) years old, and the patients were treated with tension band fixation. According to Colton classification, there were 5 cases of type I, 3 cases of type II A,19 cases of type II B, and 8 cases of type II C in group A. Among 20 patients in group B, there were 13 males and 7 females, ranging in age from 27 to 50 years old, with an average of (41.5 ± 9.3) years old. The patients in group B were treated with hollow lag screw fixation. According to Colton classification, there were 4 cases of type I, 4 cases of type II A, and 12 cases of type II B in group B. In group C, there were 27 patients totally, including 15 males and 12 females, ranging in age from 30 to 55 years old, with an average of (38.2 ± 6.2) years old. The patients in group C were treated with anatomical plate fixation. According to Colton classification, there were 4 cases of type II B, 13 cases of type II C, and 10 cases of type II D in group C. The Fracture healing time, complications and functional recovery were retrospectively observed and recorded.

RESULTSAll the patients were followed up, and the duration ranged from 8 to 24 months, with an average of 15 months. The average healing time of patients in group C was the longest among three groups. The flexion-extension and rotation activities of elbow joint in group B and C were better than that in group C. According to Broberg & Morrey score system, the therapeutic effects of patients in group A and B were better than that of group C. In group C, 2 patients had incision infections, 6 patients complained of foreign body sensation, 1 patient got a delayed fracture healing, and 1 patient had the heterotopic ossification. There were no occurrences of incision infections in group A and B; internal fixation loosening occurred in 3 patients in group A and 2 patients in group B; delayed fracture healing occurred in 2 patients in group A and 2 patients in group B; and skin bursa formation occurred in 6 patients in group A and 1 patient in group B.

CONCLUSIONAll the three ways are effective methods for the treatment of olecranon fractures. Fixation methods should be selected depending on the type of fracture.

Adult ; Bone Plates ; Bone Screws ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Olecranon Process ; injuries ; Ulna Fractures ; surgery

PURPOSE: Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces. Surgical treatment aims at reducing the fracture and restoring the anatomical joint surface condition, as well as neutralizing the strain inhibiting fracture healing. The XS nail® (Intercus GmbH, Bad Blankenberg, Germany), an intramedullary implant exerting compression across the entire fracture surface, unlike plates, leaves a minimal extra-cortical profile, and can be secured with threaded locking wires, thereby retaining the anatomical reduction without displacement or steps within the articular surface, which was often found in tension band wiring. After encouraging initial results, the long-term outcome was assessed. METHODS: This retrospective study evaluated the long-term outcome of patients surgically treated at our trauma center between January 2002 and December 2005 using the XS nail®. Patients over the age of 18 years eligible for the study must have undergone surgery for isolated, recent (less than 14 days) traumatic olecranon fractures, without concomitant injuries to the ipsilateral elbow and forearm. Further exclusion criteria were pseudarthrosis, re-fractures and osteotomy for distal humerus surgery, as well as polytraumatized patients unable to aid in their own recovery. Data were retrospectively gathered by standardised questionnaire and patient records, as well as surgery and anesthesiology reports. Data analysis was performed using Microsoft Office Excel® 2016. RESULTS: There were 32 patients, 13 males (mean age 49.0 years) and 19 females (mean age 68.9 years) with 11 Schatzkers type D, 7 each type A and C, 5 type B and 2 type E at an average of 55.2 months, all showing complete consolidation. Of them, 6 patients had a loss of range of motion with more than 10° in the sagittal plane, and only 1 patient exceeded 10° reduction of supination. Twenty-five patients reported being pain-free under all circumstances, and all but 2 patients (93.75%) had returned to their previous activity level. The average disabilities of the arm, shoulder and hand score was 21.15 (range 0-88.3), and the overall Mayo elbow performance index was 91.87, without complications, such as wound infection, neurovascular impairment or premature hardware removal. CONCLUSION Using the XS nail® system, all fracture types can be successfully treated and the rate of complications was lower than that treated by standard methods published in current literature. An excellent functional outcome, high range of motion as well as good retention of reduction without soft tissue irritation makes this a very suitable implant for fractures subject to tension.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Olecranon Process/injuries* ; Retrospective Studies ; Ulna Fractures/surgery* ; Bone Wires ; Fracture Fixation, Internal/methods* ; Fractures, Bone ; Range of Motion, Articular ; Treatment Outcome ; Elbow Injuries